公开(公告)号：US5653740A

公开(公告)日：1997-08-05

申请号：US587309

申请日：1996-01-16

申请人： Paul J. Degroot ,  Rahul Mehra

发明人： Paul J. Degroot ,  Rahul Mehra

IPC分类号： A61N1/38

CPC分类号： A61N1/385

摘要： A method and apparatus for inducing fibrillation in a patient, for example to verify the efficacy of a defibrillator system. In the disclosed embodiment, an implantable cardioverter-defibrillator has an output stage coupled via a plurality of leads to the patient's heart. When it is desired to induce fibrillation in the patient, the device's control circuitry initiates an output capacitor charging cycle and subsequent delivery of a multi-phase fibrillation inducing stimulus to the heart. The multiple phases of the stimulus reflect an incremental discharging of the output capacitor. In one embodiment, the stimulus has three phases, with the first two separated by a time interval equal to or slightly less than the patient's "vulnerability window," which is defined as the time period following a paced cardiac event during which repolarization of the cardiac muscle is occurring, rendering the heart susceptible to induced fibrillation. The final phase of the multi-phase waveform reflects an untruncated discharge of the remaining energy on the output capacitor.

摘要翻译： 一种用于在患者中诱导纤维性颤动的方法和装置，例如以验证除颤器系统的功效。 在所公开的实施例中，植入式心律转复除颤器具有通过多条引线耦合到患者心脏的输出级。 当期望在患者体内引起原纤维化时，该装置的控制电路启动输出电容器充电循环，并随后向心脏递送诱导多相纤颤的刺激。 刺激的多个相位反映输出电容器的增量放电。 在一个实施例中，刺激具有三个阶段，前两个时间间隔等于或略小于患者的“脆弱性窗口”，该时间间隔被定义为心脏事件复位后的心跳事件之后的时间段 肌肉正在发生，使心脏易受诱发纤颤。 多相波形的最后阶段反映出输出电容器上剩余能量的未经截断的放电。

公开(公告)号：US07149577B2

公开(公告)日：2006-12-12

申请号：US10307687

申请日：2002-12-02

申请人： Vinod Sharma ,  Paul J. Degroot ,  Rahul Mehra

发明人： Vinod Sharma ,  Paul J. Degroot ,  Rahul Mehra

IPC分类号： A61N1/362 ,  A61N1/38 ,  A61N1/39

CPC分类号： A61N1/3956 ,  A61N1/3622

摘要： An apparatus for discriminating between cardiac events that includes an input circuit receiving signals indicative of the cardiac events, a first output circuit generating pulses in response to the received signals, and a microprocessor determining whether a signal received by the input circuit subsequent to the generated pacing pulses corresponds to a predetermined cardiac event in response to an elapsed time period between the generated pulses and the subsequently received signal and a predetermined discrimination threshold.

摘要翻译： 一种用于区分心脏事件的装置，包括接收指示心脏事件的信号的输入电路，响应于接收到的信号产生脉冲的第一输出电路和微处理器，确定在产生的起搏之后由输入电路接收到的信号 响应于所产生的脉冲与随后接收的信号之间的经过时间段和预定的鉴别阈值，脉冲对应于预定的心脏事件。

公开(公告)号：US07181273B2

公开(公告)日：2007-02-20

申请号：US10418853

申请日：2003-04-18

申请人： William J. Havel ,  Paul J. Degroot ,  Paul M. Stein

发明人： William J. Havel ,  Paul J. Degroot ,  Paul M. Stein

IPC分类号： A61N1/39

CPC分类号： A61N1/3987 ,  A61N1/3956

摘要： An implantable medical device (IMD) provides for adaptive timing of the delivery of cardioversion shocks. In particular, the invention IMD provides for an adaptive cardioversion synchronization delay with respect to a cardiac event, such as a sensed P-wave or R-wave. When cardioversion with a first synchronization delay fails to terminate a tachycardia, for example, cardioversion may be attempted again with a second synchronization delay. The IMD may keep track of whether each synchronization delay is effective in terminating the tachycardia, and may employ a historically effective synchronization delay when applying cardioversion therapy to treat a subsequent tachycardia episode.

摘要翻译： 可植入医疗设备（IMD）提供了心脏复律冲击的适应性定时。 特别地，本发明IMD提供关于心脏事件（例如感测的P波或R波）的自适应心脏复律同步延迟。 当具有第一同步延迟的心脏复律不能终止心动过速时，例如，可以以第二同步延迟再次尝试心脏复律。 IMD可以跟踪每个同步延迟是否有效终止心动过速，并且当应用心脏复律治疗以治疗随后的心动过速发作时，可以采用历史上有效的同步延迟。

公开(公告)号：US07200434B2

公开(公告)日：2007-04-03

申请号：US11089798

申请日：2005-03-25

申请人： William J. Havel ,  Paul J. Degroot ,  Thomas W. Sinner ,  Kevin Kuehn ,  Gary Kemmetmueller ,  Warren W. Wold

发明人： William J. Havel ,  Paul J. Degroot ,  Thomas W. Sinner ,  Kevin Kuehn ,  Gary Kemmetmueller ,  Warren W. Wold

IPC分类号： A61N1/39

CPC分类号： A61N1/3906 ,  A61N1/3912 ,  A61N1/3937

摘要： The present invention outlines structures and methods for delivering a controllable amount of energy to a patient by automatically compensating for the load impedance detected by an implantable-cardioverter defibrillator (ICD). The invention employs high speed, switching power converter technology for the efficient generation of high energy, arbitrarywaveforms. Unlike a linear amplifier, switching power converters deliver high-energy waveforms with an efficiency that is independent of the size and amplitude of the desired waveform. An ICD that uses a switching power converter to deliver the desired energy to the patient stores the energy to be delivered in a storage capacitor. The converter then transforms this energy into an arbitrarily shaped output voltage-controlled or current-controlled waveform by switching the storage capacitor in and out of the output circuit at a high rate of speed. Preferably, the waveform comprises a ramp-type waveform.

摘要翻译： 本发明概述了通过自动补偿由可植入式心律转复除颤器（ICD）检测的负载阻抗来向患者传送可控量的能量的结构和方法。 本发明采用高速，开关电源转换器技术，有效地生成高能量，任意波形。 与线性放大器不同，开关电源转换器提供高能量波形，效率与所需波形的大小和幅度无关。 使用开关功率转换器将期望的能量递送到患者的ICD存储要在存储电容器中传递的能量。 然后，转换器通过以高速率切换存储电容器输入和输出输出电路，将该能量转换成任意形状的输出电压控制或电流控制波形。 优选地，波形包括斜坡型波形。

公开(公告)号：US07110813B2

公开(公告)日：2006-09-19

申请号：US10413001

申请日：2003-04-15

申请人： Paul J. Degroot ,  Kevin T. Ousdigian

发明人： Paul J. Degroot ,  Kevin T. Ousdigian

IPC分类号： A61N1/38

CPC分类号： A61N1/3956 ,  A61N1/3622

摘要： An implantable medical device may be programmed by a programmer to apply a variety of ventricular fibrillation (VF) and ventricular tachycardia (VT) therapies, such as antitachycardia pacing (ATP) and cardioversion shocks. In general, the invention is directed to automatic activation of VF- and VT-related functions upon a single command. When a clinician interacts with the programmer to set VF therapies to active status, for example, VT therapies are automatically set to active status as well. Activation of several VF- and VT-related functions with a single command may save considerable time and may be beneficial to the patient. The invention further provides the freedom to customize the functions to the particular needs of a single patient or a group of patients.

摘要翻译： 植入式医疗装置可以由程序员编程以应用各种心室颤动（VF）和室性心动过速（VT）疗法，例如抗心动过速起搏（ATP）和心律转复休克。 通常，本发明涉及在单个命令上自动激活VF和VT相关功能。 当临床医生与程序员进行交互以将VF治疗设置为活动状态时，例如，VT治疗也会自动设置为活动状态。 通过单个命令激活几个VF和VT相关功能可以节省大量的时间并且可能对患者有益。 本发明还提供了根据单个患者或一组患者的特定需要来定制功能的自由度。

公开(公告)号：US08478399B2

公开(公告)日：2013-07-02

申请号：US11343346

申请日：2006-01-31

申请人： Paul J. Degroot ,  Karel F. A. A. Smits ,  William J. Flickinger

发明人： Paul J. Degroot ,  Karel F. A. A. Smits ,  William J. Flickinger

IPC分类号： A61N1/00

CPC分类号： A61N1/3962 ,  A61N1/3621 ,  A61N1/36535 ,  A61N1/36542

摘要： An implantable medical device and method are provided for determining if a patient is in a substantially horizontal position and delaying a programmed cardioversion/defibrillation shock therapy in response to determining the patient is in a substantially horizontal position. In various embodiments, the shock therapy may be delayed by adjusting tachycardia detection criteria or scheduling the shock therapy after a maximum tachycardia episode duration.

摘要翻译： 提供了可植入医疗装置和方法，用于确定患者是否处于基本上水平的位置，并且响应于确定患者处于基本上水平的位置而延迟编程的心脏复律/除颤休克疗法。 在各种实施例中，通过调节心动过速检测标准或在最大心动过速发作持续时间之后安排休克疗法可以延迟休克疗法。

公开(公告)号：US06931279B2

公开(公告)日：2005-08-16

申请号：US10131560

申请日：2002-04-22

申请人： Kevin T. Ousdigian ,  Seema Padmanabhan ,  James E. Willenbring ,  Paul G. Krause ,  James H. Ericksen ,  Paul J. Degroot

发明人： Kevin T. Ousdigian ,  Seema Padmanabhan ,  James E. Willenbring ,  Paul G. Krause ,  James H. Ericksen ,  Paul J. Degroot

IPC分类号： A61N1/372 ,  A61N1/39

CPC分类号： A61N1/3943 ,  A61N1/37247

摘要： The invention provides systems to prevent the delivery of anti-tachycardia pacing (ATP) following a defibrillation threshold (DFT) induction at implant. An algorithm that classifies episodes as induced or spontaneous is implemented, thereby enabling the ATP during charging feature to be operable only when spontaneous episodes are detected while temporarily suspending the ATP feature during the delivery of defibrillation shock after induction has been confirmed. Further, a user interface enables users to interact with an implantable medical device (IMD), particularly for setting a defibrillation threshold (DFT) or a 50 Hz burst from a single programmer screen. The user interface includes various functionalities to promote quick user access to parameters that govern diagnosis, therapy and other features of the IMD. A single screen enables the user to complete automatic and/or manual DFT inductions or a 50 Hz burst from a programmer interface while acquiring associated documentation from the same interface.

摘要翻译： 本发明提供了防止在植入物中除颤阈值（DFT）诱导后递送抗心动过速起搏（ATP）的系统。 实施了将发作分类为诱导或自发的算法，从而使得在充电特征期间的ATP仅在检测到自发发作时才可操作，同时在确认诱导后的除颤休克期间暂时停止ATP特征。 此外，用户界面使得用户能够与可植入医疗装置（IMD）进行交互，特别是用于从单个编程器屏幕设置除颤阈值（DFT）或50Hz脉冲串。 用户界面包括各种功能，以促进用户快速访问管理IMD诊断，治疗和其他功能的参数。 单个屏幕使用户能够在从同一接口获取相关文档的同时，从编程器接口完成自动和/或手动DFT感应或50 Hz突发。

公开(公告)号：US5534873A

公开(公告)日：1996-07-09

申请号：US385057

申请日：1995-02-07

申请人： Alan R. Weichman ,  Barton G. Ferrell ,  William G. Butters ,  Gregory Murden ,  Phillip D. Alldredge ,  L. Adam Latham ,  Mike J. Courtney ,  Paul J. Degroot

发明人： Alan R. Weichman ,  Barton G. Ferrell ,  William G. Butters ,  Gregory Murden ,  Phillip D. Alldredge ,  L. Adam Latham ,  Mike J. Courtney ,  Paul J. Degroot

IPC分类号： G01S7/41 ,  G01S13/86 ,  G01S7/40

CPC分类号： G01S7/414 ,  G01S13/86 ,  G01S7/411

摘要： A method for determining the far field radar signature of relatively large and complex objects, like a fighter aircraft, and the facility to provide the data for the method. The method includes reflecting different frequencies of near field radar energy off of an object while translating the object in a radial direction with respect to the radar so the resulting radar return includes a moving signal representative of the radar return of the object and a stationary return representative of environmental clutter. The environmental clutter and R 4 amplitude variations caused by signal strength variations due to the different overall reflection distances during translation are removed from the radar signal. Multipath reflections may also be removed. The resultant signal is transformed from a spherical wave to a cylindrical wave so that for objects having a major dimension that is presented to the radar with respect to a much smaller minor dimension at right angles thereto, the radar signature as determined by the method is almost identical to that obtainable at a far field radar range. In addition, the facility includes an electromagnetically shielded building, object translating devices with position feedback, object rotators, and a computer to perform the transformations.

摘要翻译： 一种确定相对较大和复杂物体（如战斗机）的远场雷达签名的方法，以及提供该方法数据的设施。 该方法包括将物体的近场雷达能量的不同频率反射离开物体，同时相对于雷达在径向方向上折射物体，使得所得到的雷达返回包括表示物体的雷达返回的运动信号和固定回波代表 的环境杂乱。 从雷达信号中去除由于平移期间不同的总反射距离引起的信号强度变化引起的环境杂波和R 4振幅变化。 多路径反射也可能被删除。 所得到的信号从球面波变换为圆柱波，使得对于具有相对于与其成直角的小得多的小尺寸呈现给雷达的主要尺寸的物体，由该方法确定的雷达签名几乎 与远场雷达射程相同。 此外，该设施包括电磁屏蔽建筑物，具有位置反馈的物体平移装置，物体旋转器和用于执行变换的计算机。

公开(公告)号：US07474920B2

公开(公告)日：2009-01-06

申请号：US11302092

申请日：2005-12-12

申请人： John E. Burnes ,  Paul J. Degroot

发明人： John E. Burnes ,  Paul J. Degroot

IPC分类号： A61N1/39 ,  A61B5/0464

CPC分类号： A61N1/3621 ,  A61N1/3962

摘要： A device and method to detect slow ventricular tachycardia, deliver anti-tachycardia pacing therapies, and delay a scheduled shock therapy if the ventricular tachycardia is not terminated or accelerated. Preferably, a shock therapy is delayed after verifying hemodynamic stability based on a hemodynamic sensor. After a shock is delayed, the device operates in a high alert mode for redetecting an accelerated tachycardia. Anti-tachycardia pacing therapies are repeated during the shock delay. A number of conditions can trigger delivery of the delayed shock therapy including a specified period of elapsed time; determination that the patient is likely to be asleep; detection of myocardial ischemia; detection of compromised hemodynamics, or detection of a substantially prone position or sudden change in position. A delayed shock therapy may be triggered by the patient and repeated delivery of painful shock therapies in patients that are not seriously compromised by a recurring, slow ventricular tachycardia is avoided.

摘要翻译： 一种检测慢性心室性心动过速的装置和方法，提供抗心动过速起搏治疗，并且如果室性心动过速未终止或加速则延迟预定的休克疗法。 优选地，在基于血液动力学传感器验证血液动力学稳定性之后延迟了休克疗法。 在休克被延迟之后，该装置在高警戒模式下操作以重新检测加速的心动过速。 抗心动过速起搏治疗在休克延迟期间重复。 许多情况可以触发迟发性休克疗法的输送，包括指定的经过时间; 确定患者可能睡着了; 检测心肌缺血; 检测受损的血液动力学，或检测到基本上俯卧位或突然改变位置。 延迟性休克疗法可能由患者触发，并且在不被重复的慢性室性心动过速严重损害的患者中重复递送疼痛性休克疗法。

公开(公告)号：US07107098B2

公开(公告)日：2006-09-12

申请号：US10368991

申请日：2003-02-20

申请人： Vinod Sharma ,  Paul J. Degroot

发明人： Vinod Sharma ,  Paul J. Degroot

IPC分类号： A61N1/362

CPC分类号： G06F19/3481 ,  A61N1/3621 ,  A61N1/3956 ,  G06F19/00 ,  G16H40/63

摘要： A method and apparatus for generating and selecting therapies, or hierarchies of therapies, that may be used to treat episodes of atrial or ventricular tachycardia. A characteristic of a detected tachycardia event is determined, and a hierarchy of therapies to treat the detected tachycardia event is selected in response to the determined characteristic.

摘要翻译： 用于产生和选择可用于治疗心房或室性心动过速发作的疗法或疗法等级的方法和装置。 确定检测到的心动过速事件的特征，并且响应于所确定的特征选择治疗所检测到的心动过速事件的治疗层级。